A novel cardiac output response to stress test developed to improve diagnosis and monitoring of heart failure in primary care

<strong>Aims</strong> Primary care physicians lack access to an objective cardiac function test. This study for the first time describes a novel cardiac output response to stress (CORS) test developed to improve diagnosis and monitoring of heart failure in primary care and investigates i...

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Bibliographic Details
Main Authors: Hobbs, F, Charman, S, Okwose, N, Stefanetti, R, Bailey, K, Skinner, J, Ristic, A, Seferovic, P, Scott, M, Turley, S, Fuat, A, Mant, J, MacGowan, G, Jakovljevic, D
Format: Journal article
Published: John Wiley & Sons 2018
Description
Summary:<strong>Aims</strong> Primary care physicians lack access to an objective cardiac function test. This study for the first time describes a novel cardiac output response to stress (CORS) test developed to improve diagnosis and monitoring of heart failure in primary care and investigates its reproducibility. <strong>Methods and results</strong> Prospective observational study recruited 32 consecutive primary care patients (age, 63 ± 9 years; female, n = 18). Cardiac output was measured continuously using the bioreactance method in supine and standing positions and during two 3 min stages of a step‐exercise protocol (10 and 15 steps per minute) using a 15 cm height bench. The CORS test was performed on two occasions, i.e. Test 1 and Test 2. There was no significant difference between repeated measures of cardiac output and stroke volume at supine standing and Stage 1 and Stage 2 step exercises (all P &gt; 0.3). There was a significant positive relationship between Test 1 and Test 2 cardiac outputs (r = 0.92, P = 0.01 with coefficient of variation of 7.1%). The mean difference in cardiac output (with upper and lower limits of agreement) between Test 1 and Test 2 was 0.1 (−1.9 to 2.1) L/min, combining supine, standing, and step‐exercise data. <strong>Conclusions</strong> The CORS, as a novel test for objective evaluation of cardiac function, demonstrates acceptable reproducibility and can potentially be implemented in primary care.